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Clinical Moment

How Can Nurses Stay Resilient and Engaged During a Long and Ever-Changing Career Path?

Sue Childress
CJON 2019, 23(6), 672 DOI: 10.1188/19.CJON.672

Forty years ago, on a New Hampshire hilltop, I received my nursing pin as a new graduate from nursing school. A white dress, bright white stockings, and nursing shoes were the order of the day, along with a red rose. Despite the trend away from caps, I secretly loved my nursing cap with its blue velvet stripe. But, the nursing world moved on and, by the end of my first year in practice, nursing caps had become a relic of the past. Looking at a picture from that day, with my favorite professor on the chapel steps, I notice the cap is just a little crooked, but my smile is big. How did that young nurse survive the next 40 years?

Forty years ago, on a New Hampshire hilltop, I received my nursing pin as a new graduate from nursing school. A white dress, bright white stockings, and nursing shoes were the order of the day, along with a red rose. Despite the trend away from caps, I secretly loved my nursing cap with its blue velvet stripe. But, the nursing world moved on and, by the end of my first year in practice, nursing caps had become a relic of the past. Looking at a picture from that day, with my favorite professor on the chapel steps, I notice the cap is just a little crooked, but my smile is big. How did that young nurse survive the next 40 years?

I do not remember the caution of compassion fatigue or the topic of resiliency that our new graduates hear these days. My instructors drilled us in medication knowledge, thorough physical examinations, and the tightness of my bed linens.

And yet, does something need a name to be present? Remembering my first patient death still brings on a feeling of sadness. Navigating physician relationships when advocating for my patients’ pain needs—and not always succeeding—and, of course, the many shifts of working “short” were also difficulties. There were certainly days when I went home exhausted, doubting my abilities and questioning my choice in profession.

As I ask myself how I survived 40 years, I keep returning to my colleagues. Some of the friendships I formed that first year have lasted the entire 40 years. We remember not only specific patients, but also details such as their room number and, more importantly, how they made us feel. The other thing I remember is my manager, who addressed workload, encouraged educational opportunities, and modeled conversations with physicians and administrators that kept the focus on patients. She also encouraged participation in our local professional nursing organization that helped shape my career trajectory. As one of my first mentors, she gave me a strong foundation to start my career. 

Today, in my role as the director of nursing services at a comprehensive cancer center, I take compassion fatigue and the need to build resiliency very seriously. I know that when nurses suffer from compassion fatigue, they lose the ability to be empathetic, which can lead to cynicism, incivility, patient safety issues, decreased patient satisfaction scores, and high turnover (Childress, 2015; Perlo et al., 2017). Nurses who had started their careers just as I had, with high hopes, are at risk for leaving our profession. This affects a hospital’s bottom line, and it also affects nursing as a whole.

What can we do to support our young colleagues and boost their resiliency? A quick review of the literature more than acknowledges the burnout and compassion fatigue related to the challenging and sometimes unavoidable aspects of health care. There are also many studies that support evidence-based practices to address these issues. Joy at work comes with meaningful work; unfortunately, this work also comes with a price tag. It is critical that nurses appreciate these realities and that we hardwire our organizations with solutions.

These days, my nursing cap sits on a shelf at work, a little dusty, and still tipped at a crooked angle. I know that the nurses graduating this year have many different challenges than I had and will need different skills, but, at the end of the day, it is about supporting them with appropriate workloads and processes, promoting a civil and caring culture, and providing a strong manager to keep the focus on our patients.

About the Author(s)

Sue Childress, MN, RN, OCN®, is the director of nursing services at Huntsman Cancer Hospital at the University of Utah in Salt Lake City. Childress can be reached at susan.childress@hci.utah.edu, with copy to CJONEditor@ons.org.

 

References 

Childress, S.B. (2015). Team communication: It’s about patient safety. Journal of Oncology Practice, 11, 23–25.

Perlo, J., Balik, B., Swenson, S., Kabcenell, A., Landsman, J., & Feeley, D. (2017). IHI framework for improving joy in work. IHI white paper. Retrieved from http://bit.ly/327s20N